Purpose: The objective of this study was to determine the risk factors and the rate of reoperation after closed reduction percutaneous pinning (CRPP) of isolated closed single-digit proximal phalanx fractures.
Methods: A retrospective cohort study was conducted for patients who underwent CRPP of non-thumb closed proximal phalanx fractures between 2010 and 2020 at two level-I trauma centers and two community teaching hospitals. Demographics, fracture, and treatment characteristics were collected. The primary outcome measure was reoperation. Secondary outcome measures were complication and reoperation specifically for digital stiffness.
Results: Of the 115 patients who underwent surgical treatment, 46 patients (40.0%) had a complication and 13 patients (11.3%) underwent reoperation at a mean of 6.7 months-most of which (84.6%) were for digital stiffness.
Conclusions: Surgeons and patients may be aware that CRPP of closed extra-articular proximal phalanx fractures carries considerable rates of complication and reoperation.
Type Of Study/level Of Evidence: Therapeutic III.
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http://dx.doi.org/10.1016/j.jhsg.2023.11.004 | DOI Listing |
Plast Reconstr Surg Glob Open
January 2025
From the Department of Orthopedic Surgery, Japanese Red Cross, Aichi Medical Center, Nagoya Daiichi Hospital, Nagoya, Aichi, Japan.
Background: The objective of this study was to propose a novel classification for lateral polydactyly of the foot that integrates both visual appearance and radiographic findings and to delineate surgical techniques and their outcomes based on this classification.
Methods: This study enrolled 148 feet from 126 patients who underwent initial surgery at our hospital between January 2009 and July 2021. The new classification system was derived from visual appearance according to the Hirase classification and radiological bifurcation level (D: distal or middle phalanx, P: proximal phalanx, and M: metatarsal).
J Hand Surg Am
January 2025
Department of Orthopaedic Surgery, University of Utah Hospital, Salt Lake City, UT. Electronic address:
Purpose: Controversy exists regarding the optimal imaging modality (magnetic resonance imaging, ultrasound, stress radiographs) for identification of patients with grossly unstable thumb metacarpophalangeal (MCP) ulnar collateral ligament (UCL) injuries or Stener lesions. We characterize a radiographic sign for this purpose. The "displaced fleck sign" is a small avulsion fracture from the ulnar proximal phalanx base that is displaced proximal to the MCP joint line.
View Article and Find Full Text PDFBackground: Kirschner wire (K-wire) and intramedullary (IM) screw fixation are accepted techniques for treatment of unstable proximal phalanx fractures, but comparative reports are lacking. This study aimed to evaluate early clinical outcomes following treatment with K-wire or IM fixation.
Methods: A retrospective review of all proximal phalanx fractures treated surgically at a single center by multiple surgeons was performed from May 1, 2019 to March 1, 2024.
Microsurgery
January 2025
Department of Orthopedic Surgery and Plastic Surgery, Emory University, Atlanta, Georgia, USA.
Background: Loss of key-pinch sensation after median nerve injury poses significant functional detriment. Nerve transfers are utilized to improve function after nerve injury and size matching of donor and recipient nerves is important to optimize success. This anthropometric study investigates the anatomy of the superficial branch of the radial nerve (SBRN) to the thumb and index finger and explores radial to median sensory nerve transfers, a necessary but not heavily discussed facet of nerve transfers for the hand.
View Article and Find Full Text PDFInt J Surg Case Rep
January 2025
Department of Orthopaedics and Traumatology, AZ Delta, Deltalaan 1, 8800 Roeselare, Belgium; Department of Cardio and Organ Systems, Hasselt University, Martelarenlaan 42, 3500 Hasselt, Belgium. Electronic address:
Introduction: Proximal phalanx fractures in children, especially mid-diaphyseal fractures, can result in malunion and significant functional impairment. Early malunions require prompt and effective intervention to prevent long-term complications. This case study highlights the use of intramedullary headless compression screw (IMHCS) fixation in addressing a proximal phalanx malunion.
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